Emergency Health Care Workers' Preparedness and Willingness to Respond to a Dirty Bomb-related Disaster in Pakistan

Objective: Our study examined the association between willingness-to-respond (WTR) and behavioral factors, demographics, and work-related characteristics among emergency department healthcare workers (HCWs) toward a radiological dispersal device (RDD) (“dirty bomb”) blast scenario in Pakistan. Methods: A cross-sectional survey was conducted in August to September 2022 among emergency department HCWs from 2 hospitals in Karachi, Pakistan. Nonprobability purposive sampling was used to recruit participants. Multivariate logistic regression analyses were performed to examine the association between WTR and key attitudes/beliefs, including perceived norms, preparedness, and safety, as well as the EPPM variables. Results: Among behavioral factors, perceived likelihood that colleagues will report to work duty, perceived importance of one’s role, and psychological preparedness showed particularly significant associations with WTR; 53.6% of participants indicated low perceived threat, while 46.43% showed high perceived threat, toward an RDD disaster scenario. Conclusion: Our findings point to the need to improve WTR toward an RDD event by shifting behavioral factors among HCWs through efficacy-focused training; enhancing WTR through such training strategies is imperative beyond mere delivery of information. Changing norms around response, along with institutional support, may further boost WTR during RDD emergencies.